GI- Antiviral For Hepatitis B And C Flashcards Preview

Pharmacology & Drugs > GI- Antiviral For Hepatitis B And C > Flashcards

Flashcards in GI- Antiviral For Hepatitis B And C Deck (43):
1

Which patients can and cannot be given interferon alpha as a treatment

Only given in patients with well compensated livers, as noncompensated cirrhosis patients may lead to liver failure

2

What is the difference in pharmacokenetics between interferon alpha 2b and PEGylated interferon alpha 2a/2b

Regular interferon 2b has to be given daily
PEG has a longer half-life, more consistent blood levels, and slower clearance

3

What is the mechanism that administration of interferon alpha helps to clear a viral infection

-Infected cells will undergo lysosomes lysis
-Macrophages and NK cells are stimulated to clear infected cells
-Healthy cells upregulate antiviral properties.

4

What is the mechanism of action of interferon alpha

-Binds to JAk1 and tyrosine kinase 2 (TYK2)
-Activation of STAT
-Transcription of interferon stimulated genes

5

What are the proteins created by healthy cells as a result of transcription due to interferon alpha

-ZAP
-IFIT family
-OAS-RNAseL pathway
-PKR

6

What is the cause of the hepatitis “flare” as a result of interferon alpha administration

-HBV antigens decrease, and the ALT levels increase
-Caused by the interferon causing the lysis of the infected hepatocytes, so we see some liver damage, but also a decrease in the HBV levels

7

WHat are the contraindications and side effects of interferon administration

Contraindicated:pregnant or pts with cirrhosis
Side effects: Bone marrow suppression, neurotoxicity, flu like syndrome

8

What is the target for nucleoside and nucleotide based anti-hep drugs

DNA reverse transcriptase and DNA polymerase inhibitors

9

Can nucleosides and nucleotides be used in patients with cirrhosis

Yes

10

What is the mechanism of action for NRTI

Aka nucleoside/nucleotide reverse transcriptase inhibitors
-Inhibits the replication machinery of HBV and HCV

11

What is required for NRTIs to work properly

Kinase activities that convert the nucleosides into nucleotides

12

What is the group on nucleosides/tides that prevent the hepatitis virus from being able to replicate

The lack of OH groups

13

What are the nucleoside analogues used to treat HBV infection

-Lamivudine
-Telbivudine
-Entecavir

14

What are the nucleotide analogues used to treat HBV infection

Tenofovir
Adefovir

15

What is the mechanism of action for tenofovir

Adenosine nucleotide analog

16

What is the first line treatment for wild type HBV

Tenofovir

17

What patients can be administered tenofovir

Patients with resistance to lamivudine, telbivudine, or entecavir
*Due to resistance to tenofovir being rare

18

Which patients should avoid treatment with tenofovir

Those with kidney issues as is a strong proximal renal tubule nephrotoxin

19

What is the mechanism of action for entecavir

Guanosine nucleoside analog

20

What is the relation of resistance to entecavir

-Rare to be resistant in a naive patient
-Resistance to lamivudine gives about 50% resistance to entecavir

21

What is the better choice of drug for hepatitis B in those patients with renal insufficiency

Entecavir

22

What is the rate of resistance in lamivudine

Long term efficacy is not good due to the frequent mutation in the catalytic domain of HBV polymerase

23

What is the mutation in HBV polymerase that leads to decreased efficacy of long term treatment of lamivudine

YMDD to YVDD (methionine to valine)

24

In 2011, what was the standard of treatment for HCV that had some success

PEGylated interferon alpha + ribavirin

25

What is the mechanism of action for ribavirin

-Guanosine nucleotide that interferes with GTP production
-inhibits the capping of viral mRNA
-Inhibits viral RNA polymerase
-Upregulates interferon stimulated genes (ISGs)

26

What are the complication of ribavirin

-Anemia
-Pregnancy

27

What is the mechanism of action of telaprevir

First generation protease inhibitor at NS3 catalytic site

28

What is the mechanism of boceprevir

First generation protease inhibitor at NS3 catalytic site

29

What is the mechanism of action of simeprevir

Second generation protease inhibitor at catalytic site NS3

30

What is the mechanism of action of Sofobuvir

Nucleotide analog, NS5B inhibator, aka site NS5B in the RNA dependent RNA polymerase

31

Which genotypes of HCV are disrupted by sofosbuvir

All genotypes

32

What is the mechanism of action for ledipasvir

Inhibits NS5A

33

What is the mechanism of action for elbasvir

Inhibits NS5A

34

What is the mechanism of action for velpatasvir

Inhibits NS5A

35

Which hepatitis would the drug Ribavirin be given for

HCV

36

Which hepatitis would the drug simeprevir be given for

HCV

37

Which hepatitis would the drug telaprevir be given for

HCV

38

Which hepatitis would the drug boceprevir be given for

HCV

39

Which hepatitis would the drug grazoprevir be given for

HCV

40

Which hepatitis would the drugsofosbuvir be given for

HCV

41

Which hepatitis would the drug ledipasvir be given for

HCV

42

Which hepatitis would the drug elbasvir be given for

HCV

43

Which hepatitis would the drug velpatasvir be given for

HCV